The effects of an accelerated triage and treatment protocol on left without being seen rates and wait times of urgent patients at a military emergency department

Mil Med. 2008 Oct;173(10):999-1003. doi: 10.7205/milmed.173.10.999.


To combat increasing wait times and left without being seen (LWOBS) rates, our emergency department (ED) implemented an accelerated triage and treatment (TNT) protocol. A TNT team was allocated treatment rooms to begin management of urgent patients if a bed in the main ED was not available. A retrospective database study was performed using three separate 6-month periods: two control periods before the intervention (P1, P2) and one period after the intervention (P3). The primary outcome measures were LWOBS rate, time to evaluation, and total ED time for urgent patients. The time to be seen for EC3 patients improved from P1 to P3 by an average of 12.6 minutes (18.5%, p < 0.0001) and from P2 to P3 by an average of 12.0 minutes (17.6%, p < 0.0001). The EC3 LWOBS rate decreased from 2.0% in P1 and 1.9% in P2 to 0.8% in P3 (p < 0.0001 for both). The use of an accelerated TNT protocol was associated with a significant reduction in EC3 patient LWOBS rates and time to evaluation.

MeSH terms

  • Clinical Protocols*
  • Databases as Topic
  • Emergency Service, Hospital / statistics & numerical data*
  • Humans
  • Military Medicine*
  • Military Personnel*
  • Retrospective Studies
  • Time Factors
  • Triage / methods*
  • Waiting Lists*